U.S. patent number 7,740,013 [Application Number 10/567,924] was granted by the patent office on 2010-06-22 for oxygen concentrating apparatus and execution support method of home oxygen therapy using the same.
This patent grant is currently assigned to Teijin Pharma Limited. Invention is credited to Takayuki Ishizaki, Tadashi Miyazaki, Yoichi Okabe.
United States Patent |
7,740,013 |
Ishizaki , et al. |
June 22, 2010 |
Oxygen concentrating apparatus and execution support method of home
oxygen therapy using the same
Abstract
In order to enable a medical worker to certainly and easily know
whether a patient on a home oxygen therapy, who continues to inhale
an oxygen-enriched gas at home, performs the inhalation as
prescribed, a history of a supply condition of the oxygen-enriched
gas supplied to the patient is recorded and held as supply history
information, this supply history information is compared with a
prescription of the oxygen therapy of the patient to generate
patient's compliance information to indicate the degree to which
the oxygen therapy is performed in accordance with the
prescription, the oxygen concentrating apparatus is constructed to
be portable, and a doctor can confirm the patient's compliance
information at the time of going to a medical institution
regularly.
Inventors: |
Ishizaki; Takayuki (Yamaguchi,
JP), Miyazaki; Tadashi (Tokyo, JP), Okabe;
Yoichi (Tokyo, JP) |
Assignee: |
Teijin Pharma Limited (Tokyo,
JP)
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Family
ID: |
34190993 |
Appl.
No.: |
10/567,924 |
Filed: |
August 12, 2004 |
PCT
Filed: |
August 12, 2004 |
PCT No.: |
PCT/JP2004/011865 |
371(c)(1),(2),(4) Date: |
February 10, 2006 |
PCT
Pub. No.: |
WO2005/016426 |
PCT
Pub. Date: |
February 24, 2005 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20070023039 A1 |
Feb 1, 2007 |
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Foreign Application Priority Data
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Aug 14, 2003 [JP] |
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2003-293353 |
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Current U.S.
Class: |
128/204.21;
128/204.18 |
Current CPC
Class: |
A61M
16/10 (20130101); G16H 20/13 (20180101); A61M
16/101 (20140204); G16H 40/67 (20180101); A61M
2016/0039 (20130101); A61M 2205/52 (20130101); A61M
2205/502 (20130101); A61M 2205/3553 (20130101); A61M
2205/3375 (20130101); A61M 2202/0208 (20130101); A61M
2016/0021 (20130101); A61M 2205/3584 (20130101) |
Current International
Class: |
A61M
11/00 (20060101) |
Field of
Search: |
;128/204.23,204.21,204.18,202.22,205.23 ;600/529-543 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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62-270170 |
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Nov 1987 |
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JP |
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02-088078 |
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Mar 1990 |
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JP |
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03-143451 |
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Jun 1991 |
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JP |
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05-071894 |
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Oct 1993 |
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JP |
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10-052407 |
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Feb 1998 |
|
JP |
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08-504624 |
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May 1998 |
|
JP |
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11-314903 |
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Nov 1999 |
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JP |
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2002-214012 |
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Jul 2002 |
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JP |
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2002-272845 |
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Sep 2002 |
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JP |
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2003-062076 |
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Mar 2003 |
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JP |
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2003-175107 |
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Jun 2003 |
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JP |
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WO-94/13349 |
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Jun 1994 |
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WO |
|
Other References
International Search Report, Nov. 16, 2004. cited by other .
International Search Report dated Nov. 16, 2004. cited by other
.
JPO Office Action, App. No. 2005-513208, Dec. 1, 2009 (3 pages).
cited by other .
Office Action of Japanese Patent Application No.: 2005-513208
mailed on Feb. 24, 2009 (Japan). cited by other.
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Primary Examiner: Douglas; Steven O
Attorney, Agent or Firm: Rader, Fishman & Grauer
PLLC
Claims
The invention claimed is:
1. An oxygen concentrating apparatus which separates atmospheric
oxygen to supply an oxygen-enriched gas to a user, the oxygen
concentrating apparatus comprising: an oxygen concentrating means
for obtaining the oxygen-enriched gas by separating and
concentrating atmospheric oxygen; a detecting means for detecting
presence/absence of breathing of the user; a controlling means for
controlling in such a manner that the oxygen enriched gas is
supplied only during an inspiration period by a signal from the
detecting means; a recording means for recording supply history
information which is a history of a supply condition of the
oxygen-enriched gas supplied to the user; and an output means
and/or display means for sending and/or displaying the supply
history information that has been recorded.
2. An oxygen concentrating apparatus which separates atmospheric
oxygen to supply an oxygen enriched gas to a user, the oxygen
concentrating apparatus comprising: an oxygen concentrating means
for obtaining the oxygen-enriched gas by separating and
concentrating atmospheric oxygen; a detecting means for detecting
presence/absence of breathing of the user; a controlling means for
controlling in such a manner that the oxygen enriched gas is
supplied only during an inspiration period by a signal from the
detecting means; a recording means for recording supply history
information which is a history of supply conditions of the oxygen
enriched gas supplied to the user together with time information;
and an output means and/or display means for sending the recorded
supply history information to an outside of the apparatus together
with the time information.
3. An oxygen concentrating apparatus which separates atmospheric
oxygen to supply an oxygen enriched gas to a user, the oxygen
concentrating apparatus comprising: an oxygen concentrating means
for obtaining the oxygen-enriched gas by separating and
concentrating atmospheric oxygen; a detecting means for detecting
presence/absence of breathing of the user; a controlling means for
controlling in such a manner that the oxygen enriched gas is
supplied only during an inspiration period by a signal from the
detecting means; a recording means for recording supply history
information which is a history of supply conditions of the oxygen
enriched gas supplied to the user; and an output means and/or
display means for sending the recorded supply history information
to an outside of the apparatus, wherein the recording means records
as the supply history information (A) at least one of the supply
history information including an average use time, an average use
flow rate, an average exercise ratio, an average synchronous flow
rate, an average continuous flow rate, a breath sensing ratio, an
exercise time breath sensing ratio, and an apparatus nonuse day
count or (B) a change of at least one of the supply history
information including a use time, a use flow rate, an exercise
ratio, a synchronous flow rate, a continuous flow rate, a breath
sensing ratio, and an exercise time breath sensing ratio in a
specified period or a change thereof in a specified period
unit.
4. The oxygen concentrating apparatus as recited in any one of
claims 1 to 3, further comprising: prescription supply condition
input means for inputting a supply condition prescribed for the
user, said oxygen concentrating apparatus having arithmetic means
for calculating compliance information relating to a patient's
compliance by comparing the recorded supply condition with the
prescribed supply condition.
5. The oxygen concentrating apparatus as recited in any one of
claim 4, wherein the recording means records at least one of the
supply conditions including a supply flow rate set value of the
oxygen-enriched gas, an actually measured value of a supply flow
rate, and a history record of supply time.
6. The oxygen concentrating apparatus as recited in claim 5: an
arithmetic calculating means for calculating information of (C) at
least one of the patient's compliance information including an
average use time, an average use flow rate, an average exercise
ratio, an average synchronous flow rate, an average continuous flow
rate, a breath sensing ratio, an exercise time breath sensing
ratio, and an apparatus nonuse day count or (D) a change of at
least one of the patient's compliance information including a use
time, a use flow rate, an exercise ratio, a synchronous flow rate,
a continuous flow rate, a breath sensing ratio, and an exercise
time breath sensing ratio in a specified period or a change thereof
in a specified period unit.
7. The oxygen concentrating apparatus as recited in claim 6,
wherein the oxygen concentrating apparatus can be carried by the
user and is capable of supplying the oxygen enriched air to the
user at least during movement of the user.
8. The oxygen concentrating apparatus as recited in claim 7,
wherein an authentication check of a execution operation when at
least one of output display, and deletion of the supply history
information or the information of (C) or (D).
9. An oxygen concentrating apparatus which separates atmospheric
oxygen to supply an oxygen-enriched gas to a user, the oxygen
concentrating apparatus comprising: an oxygen concentrating means
for obtaining the oxygen-enriched gas by separating and
concentrating atmospheric oxygen; a detecting means for detecting
presence/absence of breathing of the user; a controlling means for
controlling in such a manner that the oxygen enriched gas is
supplied only during an inspiration period by a signal from the
detecting means; a recording means for recording supply history
information which is a history of a supply condition of the
oxygen-enriched gas supplied to the user and the information
includes a signal presence/absence of breathing of the user from
the detecting means; and an output means and/or display means for
sending and/or displaying the supply history information that has
been recorded.
Description
TECHNICAL FIELD
The present invention relates to an oxygen concentrating apparatus
and an execution support method of a home oxygen therapy, and
particularly to a structure in which it is possible to certainly
and easily know whether a patient on home oxygen therapy, who
continues to inhale an oxygen-enriched gas at home, performs the
inhalation as prescribed.
BACKGROUND ART
Hitherto, for a patient with a respiratory disease, a breathing gas
supplying apparatus (hereinafter also referred to as an oxygen
concentrating apparatus) for obtaining an oxygen-enriched gas by
separating and concentrating atmospheric oxygen has been developed,
and an oxygen therapy using the same has gradually become
popular.
Although there is a case where the oxygen therapy is performed
while the patient enters a medical institution, in the case where
the respiratory disease of the patient becomes chronic, and it is
necessary that the oxygen therapy is performed over a long period
of time to calm and stabilize the symptom, a medical treatment is
also performed in which the oxygen concentrating apparatus is
installed in the patient's home, the oxygen-enriched gas supplied
by this oxygen concentrating apparatus is guided to the vicinity of
the nasal cavity of the patient by using a tube member called a
cannula, and the patient inhales it. This kind of medical treatment
is especially called a domiciliary oxygen therapy or HOT (Home
Oxygen Therapy).
Since the home oxygen therapy was covered by insurance in 1985 in
Japan, this has been prescribed mainly for the chronic obstructive
pulmonary disease (COPD) and tuberculosis sequela, and the rough
number of patients is 60 to 65 per hundred thousand persons in
Japan and there are about eighty thousand persons (as of 2000). The
old Welfare Ministry respiratory failure section and the like
report that this home oxygen therapy improves the vital prognosis
of the patient. It is inferred that the reason why the home oxygen
therapy is effective is that the pulmonary circulation dynamics is
improved with the improvement of anoxemia.
The home oxygen therapy is performed in steps of (1) doctor's
medical examination of a patient, (2) doctor's issuance of a home
oxygen therapy execution written directive describing a
prescription to the patient based on the medical examination, (3)
installation of an oxygen concentrating apparatus in a patient's
home based on the written directive, (4) continuous execution of
inhalation of an oxygen-enriched gas using the oxygen concentrating
apparatus, and (5) medical examination at the time of a hospital
visit which is made regularly, for example, once a month.
DISCLOSURE OF THE INVENTION
When the home oxygen therapy is started, the doctor issues the
written directive as described above, and the prescription of the
home oxygen therapy to be received by the patient is written on
this written directive. The prescription contains (1) the oxygen
concentration of the oxygen-enriched gas to be supplied to the
patient, (2) the use flow rate and use time of the oxygen-enriched
gas to be supplied to the patient, and the like. On the other hand,
since the inhalation of the oxygen-enriched gas is performed in the
patient's home or at the place where the patient has gone, the
doctor can not directly confirm whether the inhalation is performed
and the conditions of gas supply at the site where the inhalation
is performed.
Then, it is necessary that the doctor asks the patient about
his/her condition at the time of treatment as an outpatient, which
is performed regularly, for example, once a month, and confirms
whether the inhalation is performed as prescribed. However, the
patient can give an answer different from the actual situation to
the doctor's inquiry.
Based on the result of the medical examination of the patient at
the time of the hospital visit, the result of the check, the result
of the inquiry and the like, the doctor confirms the therapy effect
of the home oxygen therapy and makes a future therapy plan, and
therefore, it becomes a significant obstacle in continuing the home
oxygen therapy that the answer of the patient to the inquiry can be
different from the fact.
Then, in addition to the inquiry to the patient, some methods have
been conventionally proposed which enable objective confirmation of
a situation in which the patient actually inhales the
oxygen-enriched gas. For example, a breathing gas supplying system
and apparatus proposed by the present applicant and disclosed in
JP-A-3-143451 is constructed such that the breathing gas supplying
apparatus (corresponding to the oxygen concentrating apparatus) is
provided with information collecting means, the information
collecting means collects and stores information including the
oxygen concentration of gas to be supplied and the flow rate, and
transmission means provided in the breathing gas supplying
apparatus transmits it to external specified receiving means
through a telephone line or the line.
However, according to the conventional structure, it is necessary
to provide the transmission means of the information in the oxygen
concentrating apparatus, and it is necessary to provide the
telephone line, wireless transmission path or the like between the
oxygen concentrating apparatus and a specified monitoring center or
the like, and further, with respect to the information received by
the monitoring center, transfer through transmission, mailing,
manual delivery or the like must be performed so that it can be
used by the doctor and the like when the patient goes to the
hospital, and therefore, the management steps are needed, and the
communication cost for transmission/reception is produced.
Besides, as a structure which can be easily achieved from the
above-mentioned related art structure, when a structure is adopted
in which the information stored by the information collecting means
is not transmitted through the transmission path, but is collected
from each oxygen concentrating apparatus in such a manner that the
person in charge, who visits the patient's home regularly, reads
the display screen or transfers the information to a carried
portable information terminal, the burden of providing and managing
the transmission path (communication path) of the information is
eliminated, however, the labor cost of the person in charge of
information collection, the management cost and the like
remain.
The invention has been made in view of the above circumstances, and
has an object to provide an oxygen concentrating apparatus which
enables a medical worker to certainly and easily know whether a
patient on a home oxygen therapy, who continues to inhale an
oxygen-enriched gas at home, performs the inhalation as prescribed,
and an execution support method of a home oxygen therapy.
In order to solve the problem, the invention provides an oxygen
concentrating apparatus having respective structures recited in
under-mentioned items 1) to 11) and an execution support method of
a home oxygen therapy using the same.
1) In an oxygen concentrating apparatus which can be carried by a
user, and separates atmospheric oxygen to supply it to the user at
least during movement of the user, the oxygen concentrating,
apparatus is characterized by comprising recording means for
recording a supply condition of an oxygen-enriched gas supplied to
the user, and output means or display means for enabling the
recorded supply condition of the oxygen-enriched gas to be
confirmed in a medical institution where regular outpatient
treatment is received.
2) The oxygen concentrating apparatus as recited in item 1),
characterized by comprising prescription supply condition input
means for inputting a supply condition prescribed for the user, and
arithmetic means for calculating a patient's compliance by
comparing the recorded supply condition with the prescribed supply
condition.
3) The oxygen concentrating apparatus as recited in item 1) or 2),
characterized in that the recording means is means for recording a
supply condition of at least one of a supply flow rate set value of
the oxygen-enriched gas, an actually measured value of a supply
flow rate, and a history record of supply time.
4) The oxygen concentrating apparatus as recited in any one of
items 1) to 3), comprising means for detecting whether a patient
breathes, wherein the recording means is means for recording a
breath detection result.
5) The oxygen concentrating apparatus as recited in any one of
items 2) to 4), wherein the arithmetic means is means for
calculating the patient's compliance of at least one of an average
use time, an average use flow rate, an average exercise ratio, an
average synchronous flow rate, an average continuous flow rate, a
breath sensing ratio, an exercise time breath sensing ratio, and an
apparatus nonuse day count.
6) The oxygen concentrating apparatus as recited in any one of
items 2) to 4), wherein the arithmetic means is means for
calculating a change of the patient's compliance of at least one of
a use time, a use flow rate, an exercise ratio, a synchronous flow
rate, a continuous flow rate, a breath sensing ratio, and an
exercise time breath sensing ratio in a specified period or a
change thereof in a specified period unit.
7) An execution support method of a home oxygen therapy comprises
recording a supply condition of an oxygen-enriched gas supplied to
a home oxygen therapy patient by a carried oxygen concentrating
apparatus, and outputting or displaying the recorded supply
condition of the oxygen-enriched gas in a medical institution into
which the oxygen concentrating apparatus is carried and in which
regular outpatient treatment is received.
8) An execution support method of a home oxygen therapy comprises
recording a supply condition of an oxygen-enriched gas supplied to
a home oxygen therapy patient by a carried oxygen concentrating
apparatus, comparing the recorded supply condition with a supply
condition previously prescribed for the patient to calculate a
patient's compliance, and outputting or displaying the calculated
patient's compliance.
9) An execution support method of a home oxygen therapy comprises
recording a supply condition of an oxygen-enriched gas supplied to
a home oxygen therapy patient by an oxygen concentrating apparatus
and a detection result as to whether the patient breathes at time
of supply, comparing the recorded supply condition with a supply
condition previously prescribed for the patient to detect a
patient's observance state of a prescription condition and to
detect whether the apparatus is used, and calculating a patient's
compliance.
10) The execution support method of the home oxygen therapy as
recited in item 9), wherein the patient's compliance is patient's
compliance information of at least one of an average use time of
the oxygen concentrating apparatus, an average use flow rate, an
average exercise ratio, an average synchronous flow rate, an
average continuous flow rate, a breath sensing ratio, an exercise
time breath sensing ratio, and an apparatus nonuse day count.
11) The execution support method of the home oxygen therapy as
recited in item 9), wherein the patient's compliance is a change of
the patient's compliance of at least one of a use time of the
oxygen concentrating apparatus, a use flow rate, an exercise ratio,
a synchronous flow rate, a continuous flow rate, a breath sensing
ratio, and an exercise time breath sensing ratio in a specified
period or a change thereof in a specified period unit.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a connection view of an oxygen concentrating apparatus of
an embodiment of the invention.
FIG. 2 is a structural view of the oxygen concentrating apparatus
of FIG. 1.
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, an oxygen concentrating apparatus of a preferred
example of an embodiment of the invention will be described with
reference to FIG. 1 and FIG. 2. FIG. 1 is a connection view of the
oxygen concentrating apparatus of the preferred example of the
embodiment of the invention, and FIG. 2 is a structural view of the
oxygen concentrating apparatus of FIG. 1.
[Structure of Oxygen Concentrating Apparatus]
As described before, an oxygen concentrating apparatus 1 of this
example is an apparatus which is used mainly for the home oxygen
therapy, and separates atmospheric nitrogen and supplies high
concentration oxygen (oxygen-enriched gas), and is a pressure
fluctuation adsorption type oxygen concentrating apparatus in which
as an adsorbent capable of adsorbing nitrogen preferentially- to
oxygen, for example, molecular sieve zeolite 5A, 13X, lithium
zeolite or the like is filled in an adsorption tube (adsorption
unit 5), and pressurized air made by an air compressing apparatus
(compressor 4) is supplied, so that oxygen is extracted.
Incidentally, when the invention is carried out, the structure of
the oxygen concentrating apparatus relating to the basic oxygen
concentrating function is not limited to the mode described here,
and an already known structure or various structures proposed in
future can be adopted.
As shown in the structural view of FIG. 2, the oxygen concentrating
apparatus 1 of this embodiment as the pressure fluctuation
adsorption type oxygen concentrating apparatus supplies the
pressurized air compressed by the compressor 4 from the atmosphere
to the adsorption tube (included in the adsorption unit 5) filled
with the adsorbent to adsorb nitrogen preferentially to oxygen,
brings the inside of the adsorption tube into a pressurized state
to adsorb nitrogen, and extracts oxygen not adsorbed. The
oxygen-enriched gas extracted from the adsorption tube and mainly
including oxygen is stored in a production tank 6, and then is
supplied from a product supply end 9 to the outside of the
apparatus 1 through an ultrasonic sensor part 7 and a breath
synchronizing part 8, and is supplied to a user (home oxygen
therapy patient) through a nasal cannula 1c which is a tube member
to transport the oxygen-enriched gas from the oxygen concentrating
apparatus 1 to the vicinity of the nasal cavity of the patient.
Here, with respect to the adsorbent, since the amount of nitrogen
which can be adsorbed in one process is determined by the amount of
the adsorbent and the kind thereof, before the amount of nitrogen
adsorbed by the adsorbent is saturated, a flow path switching valve
is switched to expose the adsorbent tube to the atmosphere, the
pressure of the inside of the adsorbent tube is reduced to desorb
nitrogen, and the adsorbent is regenerated. Besides, the flow path
switching valve is controlled by a main control part 14 so that it
is switched according to a previously set time. Incidentally, in
order to increase the amount of adsorption/desorption in one
process, the inside of the adsorption tube in the desorption
process may be made vacuous by using a vacuum pump.
Incidentally, in order to realize the oxygen concentrating
apparatus 1 of this embodiment as a portable one, which is not
fixedly installed in the patient's home, by reducing the size and
weight, it is a desirable mode that for example, a structure
disclosed in Japanese Patent No. 3269626 is used, and the
adsorption unit 5 includes rotation valve means in which a gas flow
path for pressurization and desorption to plural adsorption tubes
is successively continuously formed.
As disclosed in JP-A-2002-214012 filed by the present applicant,
the ultrasonic sensor part 7 measures propagation speeds of two
sound waves, for example, ultrasonic waves in the same direction as
and the reverse direction from a direction in which the
oxygen-enriched gas flowing in the nasal cannula 1c flows, and can
measure the actual flow rate of the oxygen-enriched gas flowing in
the nasal cannula 1c. Besides, a structure of measuring the actual
flow rate of the oxygen-enriched by using another structure and
system may be adopted.
Further, by realizing the so-called demand regulator function in
which the breath of the patient is detected, the oxygen-enriched
gas is supplied only in an aspiratory period (air is inspired) and
the supply is stopped in an expiratory period (air is expired), the
breath synchronizing part 8 saves (conserves) the amount of the
oxygen-enriched gas supplied to the patient while an influence is
not exerted on the inhalation of the patient, and consequently, in
an operation mode in which an AC power source is a power supply
source, use electric energy can be reduced, and in an operation
mode in which a rechargeable battery is a power supply source, an
operation time to next charging can be prolonged.
Incidentally, the oxygen concentrating apparatus 1 includes an
operation switch (not shown) to switch between an operation mode
(hereinafter also referred to as a synchronous mode) to supply the
oxygen-enriched gas only in the aspiratory period by detecting the
breath of the patient as stated above and an operation mode
(hereinafter also referred to as a continuous mode) to always
supply the oxygen-enriched gas at a constant flow rate irrespective
of the breath of the patient. For example, at the time of sleep,
this operation switch is operated without fail and the inhalation
of the oxygen-enriched gas is performed in the continuous mode.
This is adopted in order to continue the supply of the
oxygen-enriched gas even in the case where the patient at the time
of sleep performs the breath through the oral cavity, not the nasal
cavity and the breath is not detected.
A specific structure for detecting the breath of the patient can be
realized by, for example, a structure as disclosed in
JP-A-2002-272845 filed by the present applicant, in which after a
sound signal (breath sound of the patient) is converted into an
optical signal by using an optical microphone, it is converted into
a voltage signal and is further converted into a frequency so that
analysis in a frequency region is performed, and the breath is
detected by a difference in frequency band, a method as disclosed
in JP-A-62-270170 in which a sensor made of a pyroelectric element
is provided in a nasal cannula, a structure as disclosed in
JP-B-5-71894 in which a pressure detector is used to detect
electrostatic capacity by using a high molecular film of laminated
conductive layers and by a diaphragm pressure meter, a method as
disclosed in JP-A-2-88078 in which a pressure detector is provided
in the vicinity of an oxygen supply port of an oxygen concentrating
apparatus main body, and supply of an oxygen-enriched gas is
controlled based on the signal of the pressure detector, or the
other method.
A display part 10 is display means including a display member such
as a liquid crystal panel and a peripheral interface part, and
displays information transmitted from the main control part 14 on
the display member. The content of data displayed by the display
part 10 includes, in addition to the content displayed in a
conventional oxygen concentrating apparatus, such as a display of
an operation on state, a display of warning or alarm, and a display
of a set flow rate, as described later, information of a history of
a supply condition under which the oxygen-enriched gas is supplied,
patient's compliance information to indicate the patient observance
tendency of prescription instruction, which is obtained by
comparing the history information of the supply condition with
prescription content, and the like. The specific content of the
patient's compliance information will be described later.
An information output end 11 is an output terminal or a
transmission interface to transmit various information transmitted
from the main control part 14 to an apparatus outside the oxygen
concentrating apparatus 1, for example, a personal computer through
a wireless or wired transmission path, and may be a structure based
on RS-232C, USB, Bluetooth or other well-known communication
standards. The information to be transmitted includes, in addition
to the content displayed in a conventional oxygen concentrating
apparatus, as described later, the information of the history of
the supply condition under which the oxygen-enriched gas is
supplied, the patient's compliance information obtained by
comparing the information of the history of the supply condition
with the prescription content, and the like.
A flow rate setting part 12 is operated by the user such as the
patient and is for setting the flow rate of the oxygen-enriched gas
to be supplied, and for example, a dial switch is rotation
operated, and when a desired selection value is selected from 1
liter/minute, 2 liters/minute, 3 liters/minute and the like, the
main control part 14 having detected this selection value controls
the compressor 4, the operation speed of the adsorption unit 5 and
the like, and realizes the set desired flow rate.
The compressor 4 includes a compressor drive motor to drive the
compressor 4, and the compressor drive motor rotation drives the
compressor 4 in accordance with the drive current generated and
outputted by the power source control part 3 so that the rotation
number set by the main control part 14 is realized. A compression
mechanism part of the compressor 4 is for compressing the air by
the rotation force obtained by the compressor drive motor, and
there are various kinds according to the compression system, and a
reciprocating motion piston type, a rotation scroll type or the
like is generally often used. However, as long as the atmospheric
air can be compressed, any type may be used.
In addition to the drive current output to drive the compressor 4
as described above, the power source control part 3 has the
function to supply electric power to the respective components
included in the apparatus 1.
Incidentally, in the oxygen concentrating apparatus 1 of this
embodiment, as characteristic points for realizing a transportable
and portable structure, a power supply method from only a home AC
power source in a conventional typical fixed installation type
oxygen concentrating apparatus is improved, and a three-way power
source system is adopted which includes a built-in battery, a home
AC power source, and a vehicle-mounted DC power source. Thus, a
power source input end 2 is provided at the housing outer
peripheral part facing the outside of the apparatus, and DC
electric power can be received through this from an AC power source
unit 15 or a vehicle-mounted power source unit 16 connected to a
cigar lighter contact in an automobile.
Further, a repeatedly rechargeable battery 13 is detachably
provided inside the oxygen concentrating apparatus 1, and in the
case where power supply through the power source input end 2 can
not be performed, electric power is supplied to the power source
control part 3 by discharge from the battery 13.
Incidentally, charging to the battery 13 is generally executed in
such a manner that while the battery 13 is mounted in the oxygen
concentrating apparatus 1, electric power supplied from the AC
power source unit 15 or the vehicle-mounted power source unit 16 is
supplied via the power source input end 2 and the power source
control part 3.
The main control part 14 includes not only a function, which is
similar to that of a conventional structure oxygen concentrating
apparatus, to control the respective components of the oxygen
concentrating apparatus 1 to supply the oxygen-enriched gas, but
also a function to record and hold, at the time of supply and
whenever necessary, information (hereinafter also referred to as
supply history information) of a history of a supply condition
under which the oxygen-enriched gas is supplied, a function to
generate patient's compliance information which is obtained by
comparing the supply history information with the prescription
content of the oxygen therapy of the patient previously stored in
the main control part 14 and is information to indicate the degree
to which the patient performs the oxygen inhalation of the home
oxygen therapy as prescribed or the observance tendency of the
prescription instruction, a function to output at least one of the
supply history information and the patient's compliance information
obtained in this way through the information output end 11 to an
apparatus outside the oxygen concentrating apparatus 1, for
example, a personal computer, or to output it to the display part
10 or the other display means and to cause a display, and the like.
These functions will be described later.
Besides, as a characteristic structure for realizing the
transportable and portable function, in addition to the previously
described points, the oxygen concentrating apparatus 1 of this
embodiment includes, for example, a housing part having a necessary
degree of dust proof and water proof function and protecting the
inside of the oxygen concentrating apparatus 1, a wheel part
attached to the housing part, a holding handle similarly attached
to the housing part and the like (none of them are shown), and when
going out, the patient can carry it by pulling or the like. A
structure may be such that the wheel part is not provided, and the
patient directly carry it with a sling belt, or puts it in a
rucksack and shoulders it.
Further, in order to make the oxygen concentrating apparatus 1
portable, the mass and volume are greatly reduced from those in the
related art. For example, a conventional fixed installation type
typical oxygen concentrating apparatus has a weight of about 30 kg,
however, since the apparatus 1 of this embodiment has a weight of
less than 5 kg and is easily carried, the patient easily carries it
to the medical institution where the patient receives regular
outpatient treatment.
[Operation of the Oxygen Concentrating Apparatus]
Next, the operation of the oxygen concentrating apparatus 1 of this
embodiment will be described with reference to FIG. 1 which is a
connection view of the apparatus 1.
First, in the case where a patient 1b is in patent's home 1a and
receives the oxygen therapy, similarly to the related art, electric
power is supplied from the home AC power source, and inhalation of
the oxygen-enriched gas can be performed. When the inhalation is
performed by the driving of the battery 13 in the patient's home,
since the patient 1b carries the apparatus 1 without restriction of
the AC consent and continues the inhalation while freely moving in
the patient's home, it is possible to resolve inconvenience that
like a conventional fixed installation type apparatus, a cannula
with a long extension tube of several meters is connected to the
oxygen concentrating apparatus, and inhalation is performed through
the cannula with the extension tube.
As a characteristic point of this embodiment, when the
oxygen-enriched gas is supplied, the main control part 14 of the
apparatus 1 continuously records and holds supply history
information, which is the history of the supply condition of the
oxygen-enriched gas, as the so-called journal data, together with
time information, into an internal memory part (not shown) at all
times or suitable timing. That is, the history information of the
supply time is recorded and held.
The data included in the supply history information includes, in
addition to a supply time history (history of supply time), an
oxygen concentration of the supply gas, a supply flow rate,
information which is detected by the breath synchronizing part 8
and indicates whether the patient 1b breathes, and the like. The
information of the flow rate may be a value of a flow rate measured
by the ultrasonic sensor part 7 and actually flowing in the
cannula, a set specified flow rate, or both of them. Besides,
together with the supply history information, the other information
may be simultaneously recorded and held. The other information may
be, for example, operation information of the oxygen concentrating
apparatus 1 (information notifying the operation state of the
compressor 4, the absorption unit 5 or the like, information
indicating what supplies electric power, information of the
remaining power amount of the battery 13, information of
accumulated use time of the apparatus 1, information of oxygen
concentration of the supply air, and the like), information as to
whether the wheel part attached to the housing part rotates and the
rotation speed (by this, whether the patient 1b moves while
carrying the apparatus 1, and the movement speed are known),
information of the present position in the case where the apparatus
1 includes position detection means such as a GPS terminal, and the
like.
Alternatively, an accelerator sensor is mounted in the oxygen
concentrating apparatus 1, and information relating to the movement
of the oxygen concentrating apparatus 1 obtained from the
accelerator sensor can be made the other information which may be
simultaneously recorded. At the time of exercise, since there is a
high possibility that the patient carries the oxygen concentrating
apparatus 1, the movement situation of the patient can be directly
grasped from the record.
Further, the supply history information, the other information, and
after-mentioned patient's compliance information may be recorded
and held in independently provided memory means, not the memory in
the inside of the main control part 14, or alternatively, removable
memory means such as a Memory Stick.TM. or an SD Card.TM. is used
and at the time of going to the medical institution 2a, only the
removable memory means, not the whole oxygen concentrating
apparatus 1, is extracted and may be carried into the medical
institution 2a. Alternatively, although the patient carries the
oxygen concentrating apparatus 1 into the medical institution 2a
where regular outpatient treatment is received, as a method of
delivering the supply history information, the other information,
and the after-mentioned patient's compliance information to an
information equipment of the medical institution, the so-called
medium delivery may be performed in such a manner that after the
removable memory means is removed from the oxygen concentrating
apparatus 1, it is attached to the information equipment of the
medical institution to deliver the information.
Further, at the same time as the recording and holding of the
supply history information or at a different time point, the main
control part 14 of the apparatus 1 generates the patient's
compliance information as data indicating the degree to which the
oxygen therapy is performed as prescribed or the observance
tendency of the patient to the prescription instruction, and
records and holds it in the memory part of the main control part 14
or in the other memory means.
The patient's compliance information is obtained by comparing the
supply history information with the prescription information of the
patient previously stored in the main control part 14 or the other
memory means, and various modes are conceivable. Some of them will
be exemplified below.
Incidentally, in the following exemplification, information of the
flow rate of the oxygen-enriched gas used for the generation of the
patient's compliance information may be a flow rate set value by
the flow rate setting part 12, or a flow rate measured value by the
ultrasonic sensor part 7, or both of them may be written side by
side. Further, based on the result of the breath detection by the
breath synchronizing part 8, it may be additionally written whether
the patient actually breathes, or it is possible to indicate that
there is no data in the case where a breath is not detected.
Besides, the patient's compliance information described below can
have various modes including a construction in which an explanation
is not made, and the various modes can include information almost
equal to the supply history information in addition to a mode of
information directly indicating the patient's compliance of the
therapy. This is because according to various environmental
differences relating to the home oxygen therapy, such as
characteristics of the patient and a medical plan of a medical
worker, the mode of optimum information for acquiring the therapy
compliance of the patient can be changed. Then, in the following
description, in order to avoid the troublesomeness, with respect to
the various modes in the wide range of from the information
directly indicating the therapy compliance of the patient to the
supply history information, the name of .left brkt-top.patient's
compliance information.right brkt-bot. is used and the description
will be made.
[Example (1) of Patient's Compliance Information--Compliance Scalar
Value]
This is information indicating the therapy compliance of the
patient by a single or plural scalar values (numerical values), and
in the case where for example, the prescription says that .left
brkt-top.inhalation should be performed every day at 1 liter/minute
at the time of rest for 12 hours, 2 liters/minutes at the time of
exercise for 4 hours, and 1 liter/minute at the time of sleep for 8
hours.right brkt-bot., the consistence degree is calculated based
on daily actual supply history information and a specified
calculation method, and the value is made, for example, .left
brkt-top.compliance of 88%.right brkt-bot.. In this mode, since it
is not necessary to read a diagram such as a graph, and the
goodness of the compliance can be instantaneously understood, in
outpatient treatment in which a medical examination time for one
patient is limited, the medical worker can effectively grasp the
compliance of the patient.
With respect to the calculation method of the scalar value, some
examples will be described below. Incidentally, in these examples,
the supply history information used for the calculation is data
stored during days (for example, 30 days) from the last visit to
the medical institution to this visit thereto.
(1-1) Average Use Time Per Day
This is a calculated average time per day in which the oxygen
concentrating apparatus 1 is used, and indicates how many hours the
patient performs the inhalation of the oxygen-enriched gas, and for
example, in the case where the prescription by the medical worker
indicates the inhalation of 24 hours per day, it is of course
desirable that the value is close to that. Whether the apparatus 1
is used or not is judged based on whether the power source switch
of the apparatus 1 is in an on state, or whether the apparatus 1 in
the operation state detects the breath of the patient.
(1-2) Average Use Flow Rate
This is a value obtained by dividing the total volume of the
supplied gas by the whole use time of the apparatus 1 during the
hospital visit interval period (for example, 30 days), and
indicates an average supply flow rate during the hospital visit
interval period. Similarly, it is desirable that the value is close
to the prescribed value.
(1-3) Average Exercise Ratio (Average Synchronous Use Ratio)
This is a ratio of the synchronous mode use time to all the time
when the supply of the oxygen-enriched gas is performed. The
synchronous mode is mainly used when the oxygen-enriched gas is
supplied from the oxygen concentrating apparatus 1 by battery
driving, and in almost all cases, the patient performs an action
such as going out, working or walking, and accordingly, the medical
worker can grasp the ratio of the exercise time to all the
inhalation time, that is, the tendency of action of the
patient.
(1-4) Average Synchronous Flow Rate
This is an average value of the supply flow rate in the case where
the synchronous mode is used. This is desirable to be close to the
prescribed use flow rate at the time of exercise.
(1-5) Average Continuous Flow Rate
Similarly, this is an average value of the supply flow rate in the
case where the continuous mode is used. This is desirable to be
close to the prescribed use flow rate at the time of rest and at
the time of sleep.
(1-6) Breath Sensing Ratio
This is a ratio of a time when the breath of the patient is
detected (sensed) to all the time when the oxygen concentrating
apparatus 1 is in an operation state (state in which the
oxygen-enriched gas is supplied). Since the apparatus 1 of this
embodiment always continuously detects the breath of the patient
irrespective of the synchronous mode or the continuous mode, this
value can be calculated. In the case where this value is large, it
is conceivable that a situation is such that the patient breathes
through the oral cavity, not the nasal cavity, and the
oxygen-enriched gas is not correctly inhaled, or although the
apparatus 1 is in a drive state, for example, a cannula is not
mounted and the patient does not perform the inhalation, and in any
case, the correction is needed.
(1-7) Exercise Time Breath Sensing Ratio
Similarly, this is a ratio of a time when the breath of the patient
is detected (sensed) to all the time when the oxygen concentrating
apparatus 1 is in the synchronous mode and is in the state where
the oxygen-enriched gas is supplied, and it is possible to detect a
state (breath through the oral cavity, or the like) in which the
oxygen-enriched gas is not correctly inhaled at the time of
exercise.
(1-8) Apparatus Nonuse Day Count
This is the number of days, during the hospital visit interval
period (for example, 30 days), obtained by adding days when the
power source of the oxygen concentrating apparatus 1 is never
turned on, or the supply of the oxygen-enriched gas is never
performed. The therapy compliance of the patient can be directly
grasped. Besides, in addition to the calculation of the scalar
value as described above, the patient's compliance information may
be made a mode in which intuitive and quick grasp can be made by
imitating the traffic light colors of red, yellow, blue and the
like.
[Example (2) of Patient's Compliance Information--Change Trend
Value of Compliance Scalar Value]
This is for grasping a trend, by using the differential or the
like, of a daily change of values obtained by calculating the
above-described compliance scalar value every day, for example,
numerical values of the daily use time, use flow rate, exercise
ratio or the like, and it is possible to instantaneously understand
whether the compliance of the patient is increasing or
decreasing.
[Example (3) of Patient's Compliance Information--Intraday Change
Trend Graph of Compliance Scalar Value]
Similarly, this is such that the daily change of the values
obtained by calculating the above-described compliance scalar value
every day, for example, the numerical values of the daily use time,
use flow rate, exercise ratio or the like is made a change graph
(for example, a line graph) at every time in a specific day or in
an averaged day, and it is understood that for example, the time of
nonuse of the oxygen concentrating apparatus 1 of a certain patient
is concentrated on a specific time in the daytime.
[Example (4) of Patient's Compliance Information--Journal Data with
Prescription Information]
This is such that measured data, such as a change of a flow rate in
a day or every day in a month or detection result of breath, is
directly made a band graph or a line graph in contradistinction to
time, and the prescription value is also displayed. This is
effective in that the journal data can be minutely investigated and
carefully read while being compared with the prescription value. It
is convenient to perform classification by color for the respective
flow rates.
Incidentally, it is effective that the various compliance
information described above is made information indicating the
state of change in a specified period, such as, for example, the
intraday change graph. Here, the specified period is a day, a week,
a month, a year, or an arbitrary set period.
Further, it is also effective to structure such that the change of
the various compliance information as described above is indicated
in a specified period unit, for example, a day unit, and the state
of the change of the compliance information with the passage of
time is displayed. Similarly to the above, this specified period is
a day, a week, a month, a year, or an arbitrary set period. By
adopting the structure as stated above, the usage can be
effectively made for the grasp of the clinical state of the patient
and its change.
The patient's compliance information is generated based on not only
the supply history information in the patient's home 1a but also
that at a place 3a where the patient has gone. Then, in the day of
a hospital visit which is made regularly, for example, once a
month, the patient 1b carries the oxygen concentrating apparatus 1
to visit the medical institution, a doctor 2b of the medical
institution 2a causes the display part 10 of the apparatus 1 to
display the patient's compliance information of the above-mentioned
structure or the other structure and confirms it, or causes a
personal computer connected to the information output end 11
through a transmission cable 2e to display it and confirms it, and
consequently, from the objectively correct viewpoint, it is
possible to grasp whether the patient correctly receives the home
oxygen therapy, and the therapy effect of the home oxygen therapy
can be greatly improved.
When the patient's compliance information is displayed on a medical
institution terminal 2c of the medical institution, by the function
of a dedicated display program previously installed in the medical
institution terminal 2c, first, a menu screen (not shown) is
displayed on the display screen of the medical institution terminal
2c, a desired item name is selected from item names included on
this menu screen, for example, the foregoing .left brkt-top.average
use time per day.right brkt-bot. and .left brkt-top.average use
flow rate.right brkt-bot., and can be displayed on the display
screen of the medical institution terminal 2c. The display sequence
of the item names on the menu screen may be made the display
frequency sequence to improve the efficiency of selection work.
Incidentally, at least one of the supply history information and
the patient's compliance information may be outputted to the
outside of the apparatus 1 or may be displayed by display means.
Besides, in order to protect the privacy of the patient or to
prevent the information from being modified by the patient, the
structure may be made such that a lock is released by
authentication confirmation using a password or the like or a
physical key so that only a previously appointed medical worker can
execute the readout, display, or reset (erase) operation of the
supply history information, the patient's compliance information
and the like. For that purpose, a key is provided at the side of
the oxygen concentrating apparatus 1, or the main control part 14
may be constructed such that only in the case where a correct
password is sent from the medical institution terminal 2c connected
to receive information, the information is transmitted and
displayed.
The observed or read supply history information and the patient's
compliance information are stored and held in a personal computer
or a server, and can be used for later medical care, or can be used
for an electric medical chart, or a participating doctor 4b of a
participating medical institution 4a, who examines the patient 1b
in corporation with the doctor 2b of the medical institution 2a,
performs browsing (perusal) or reading from a second personal
computer through an Internet network 5a and can easily use it for
the participating medical care.
Further, for example, information relating to the operation state
of the oxygen concentrating apparatus 1 recorded and held
simultaneously with the supply history information is read into the
personal computer 2c of the medical institution at the time of a
hospital visit of the patient, and a check is performed by a
dedicated check program, so that the abnormality of the apparatus 1
can be quickly detected, and the structure in which the maintenance
of the oxygen concentrating apparatus 1 becomes very easy and
effective can also be sufficiently realized.
For example, the oxygen concentration of the supplied
oxygen-enriched gas is continuously measured and recorded, and in
the case where the lowering tendency of the oxygen concentration is
seen, an alarm display is performed, so that a medical worker or
the like can give an instruction of maintenance to check the
contamination of a filter of an air inlet. Alternatively, in the
case where the flow rate in the nasal cannula 1c is lower than a
normal value although the supply pressure of the oxygen-enriched
gas is normal in the oxygen concentrating apparatus 1, there is a
fear that the nasal cannula 1c is bent halfway and a jet of gas is
blocked, and accordingly, the medical worker informed of this
situation by an alarm again guides the patient in the handling of
the nasal cannula 1c at the time of inhalation, especially at the
time of sleep, and can make the correction.
EFFECTS OF THE INVENTION
The invention can provide an oxygen concentrating apparatus which
enables a medical worker to certainly and easily know whether a
patient on a home oxygen therapy, who continues to inhale an
oxygen-enriched gas at home, performs the inhalation as prescribed,
and an execution support method of the home oxygen therapy.
* * * * *